Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study

Abstract Post-stroke cognitive impairment (PSCI) significantly affects stroke survivors. Identifying modifiable risk factors for PSCI is essential. Serum multi-trace elements are crucial for neurological function but vary in concentration among older adults. It remains unclear whether increasing mul...

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Bibliographic Details
Main Authors: Ruolin Zhou, Weijie Zhai, Lingjie Meng, Chunxiao Wei, Li Sun
Format: Article
Language:English
Published: Nature Publishing Group 2025-07-01
Series:Translational Psychiatry
Online Access:https://doi.org/10.1038/s41398-025-03420-5
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Summary:Abstract Post-stroke cognitive impairment (PSCI) significantly affects stroke survivors. Identifying modifiable risk factors for PSCI is essential. Serum multi-trace elements are crucial for neurological function but vary in concentration among older adults. It remains unclear whether increasing multi-trace elements can reduce the incidence of PSCI. We investigated the associations between baseline serum multi-trace elements and PSCI. The Montreal Cognitive Assessment defined PSCI. We used logistic regression analyses to evaluate the association between serum multi-trace elements and PSCI. Subsequently, we assessed the associations between serum multi-trace elements and three different cognitive domains using the Kruskal–Wallis test. We further evaluated improvements in the predictive ability of serum multi-trace elements. Finally, 626 patients (mean age: 62.85 ± 7.54 years) were followed up for a median of 1.2 years. Lower concentrations of serum iron (odds ratio [OR] = 2.498, 95% confidence interval [CI]: 1.505–4.145) and zinc (OR = 2.015, 95% CI: 1.233–3.293) were associated with a higher PSCI risk. Higher concentrations of serum iron (OR = 0.368, 95% CI: 0.227–0.595) and magnesium (OR = 0.273, 95% CI: 0.164–0.454), along with lower concentrations of serum copper (OR = 0.544, 95% CI: 0.34–0.872), were significantly correlated with a lower PSCI risk. Cognitive impairments varied across multi-trace elements. Serum iron affected wider cognition, while magnesium and copper levels were strongly associated with language and executive function. Adding serum multi-trace elements to the conventional model improved PSCI risk reclassification (area under curve: 0.676–0.718). Multi-trace elements may influence PSCI progression. This study was registered with the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/ ; unique identifier: ChiCTR1900022675).
ISSN:2158-3188